Republic of the Philippines

Department of Education
Region III
SCHOOLS DIVISION OF NUEVA ECIJA
Brgy. Rizal, Santa Rosa, Nueva Ecija, 3101
Tel. No. (044) 940-3121

NAME: POSITION TITLE:

STATUS:
DISTRICT/ (Perm./Sub/Prom./Reclass)
SCHOOL:

CHANGE STATUS FROM PROVI TO PERMANENT

(REAPPOINTMENT)

CSC CHECKLIST
CHECKLIST FOR COMMON REQUIREMENTS (2 cps.)
CSC PROCESSING CHECKLIST (2 cps.)
WAPCO (3 cps.)
APPOINTMENT FORM (Form 33) (6 cps.)
Name of Appointee
Position
Status
Monthly Salary
Nature of Appointment
Incumbent
Indicate strand and major (below the item number)
Item Number
Publication
Signature of Appointee

PDS 2017 (3 cps.)

Name (Surname, First Name, Middle Name)
Date of Birth (MM/DD/YYYY)
Place of Birth
#26 Educational Background (College Course and Major)
#28 Work Experience
#34 to 40c (Check Yes or No)
Picture
Signature of Appointee (page 1 to 4)
Date Accomplished
Notarized

PHOTOCOPY OF PRC ID (3 cps.)

 Authenticated
Expiry Date

CERTIFICATION OF REGISTRATION (3 cps.)

Authenticated

POSITION DESCRIPTION FORM (PDF) (3 cps.)

QS of Item
Item number
School/District station
Percentage of working time
Signature of appointee and supervisor

OATH OF OFFICE (3 cps.)

Signature of appointee
Governtment ID/ID Number/Date Issued

CERTIFICATE OF ASSUMPTION TO DUTY (3 cps.)

Eff. Date of assumption
Date issued
Signature
Noted of HR

Transcript of Records of Bachelor's Degree (1 copy)

NC2 & TMC1 (if TVL) Note: Indicate in PDS (1 copy)
Atleast 6 units of Master's Degree relevant on strand (if academic strand)
Certificate of Enrollment (if currently enrolled) (1 copy)
TOR (if graduated) (1 copy)

DIVISION OFFICE CHECKLIST

Original Chit (from ASDS Gervacio) (1 copy)
Indorsement Letter from District Office/School (1 copy)
Recommendation fr. School Principal
Copy of CSC Publication (1 copy)
Updated GMIS (indicating the name of teacher) (1 copy)
Attested Copy of previous appointment as Tempo/Provi. (1 copy)

Additional requirements for GSIS Form(s):

FORM E (change of status from Provi to Permanent) (1 copy)

Note:
All xerox copy must be certified by the concerned PSDs/School Principal.

Checked and Verified:

 REYMO R. ALDAMA
SCHOOL PRINCIPAL/PSDS Administrative Officer IV/HRMO